This invention relates in general to a technique for diagnosing and treating Attention Deficit Hyperactivity Disorder (ADHD) and more particularly to a technique for modifying a person""s behavior using biofeedback and image modification.
ADHD is the most common neurobehavioral disorder of childhood as well as among the most prevalent health conditions affecting school-aged children. Between 4% and 12% of school age children (several millions) are affected. $3 billion is spent annually on behalf of students with ADHD. Moreover, in the general population, 9.2% of males and 2.9% of females are found to have behavior consistent with ADHD. Upwards of 10 million adults may be affected.
ADHD is a difficult disorder to diagnose. The core symptoms of ADHD in children include inattention, hyperactivity, and impulsivity. ADHD children may experience significant functional problems, such as school difficulties, academic underachievement, poor relationships with family and peers, and low self-esteem. Adults with ADHD often have a history of losing jobs, impulsive actions, substance abuse, and broken marriages. ADHD often goes undiagnosed if not caught at an early age and affects many adults who may not be aware of the condition. ADHD has many look-alike causes (family situations, motivations) and co-morbid conditions (depression, anxiety, learning disabilities).
Diagnosis of ADHD involves a process of elimination using written and verbal tests. However, there is no one objective, independent valid test for ADHD. Various objective techniques have been proposed but have not yet attained acceptance. These include:
1. The eye problem called convergence insufficiency was found to be three times more common in children with ADHD than in other children by University of California, San Diego researchers.
2. Infrared tracking to measure difficult-to-detect movements of children during attention tests combined with functional MRI imaging of the brain were used by psychiatrists at McLean Hospital in Belmont, Mass. to diagnose ADHD in a small group of children (Nature Medicine, Vol. 6, No. 4, April 2000, Pages 470-473).
3. Techniques based on EEG biofeedback for the diagnoses and treatment of ADHD are described by Lubar (Biofeedback and Self-Regulation, Vol. 16, No. 3, 1991, Pages 201-225).
4. U.S. Pat. No. 6,097,980, issued Aug. 1, 2000, inventor Monastra et al, discloses a quantitative electroencephalographic process assessing ADHD.
5. U.S. Pat. No. 5,913,310, issued Jun. 22, 1999, inventor Brown, discloses a video game for the diagnosis and treatment of ADHD.
6. U.S. Pat. No. 5,918,603, issued Jul. 6, 1999, inventor Brown, discloses a video game for the diagnosis and treatment of ADHD.
7. U.S. Pat. No. 5,940,801, issued Aug. 17, 1999, inventor Brown, discloses a microprocessor such as a video game for the diagnosis and treatment of ADHD.
8. U.S. Pat. No. 5,377,100, issued Dec. 27, 1994, inventors Pope et al., discloses a method of using a video game coupled with brain wave detection to treat patients with ADHD.
9. Dr. Albert Rizzo of the Integrated Media Systems Center of the University of Southern California has used Virtual Reality techniques for the detection and treatment of ADHD.
10. U.S. Pat. No. 6,053,739, inventors Stewart et al., discloses a method of using a visual display, colored visual word targets and colored visual response targets to administer an attention performance test.
11. U.S. Pat. No. 5,377,100, issued Dec. 27, 1994, inventors Patton et al., discloses a system and method of managing the psychological state of an individual using images.
There are several clinical biofeedback and physiology monitoring systems (e.g. Multi Trace, Bio Integrator). These systems are used by professional clinicians. A clinician monitors a patient""s physiologic changes and accordingly uses different protocols. Some multimedia content (e.g. images, sound) can be used during the session to display a patient""s pattern of physiologic reactivity and to help the patient in his/her task defined by the clinician. A good example is a session designed to help a patient to increase her/his hand temperature. A synthetic animation with the sun rising over the ocean can be used to show the patient""s temperature. When the patient""s temperature increases the sun is rising over the water horizon. When his/her temperature decreases the sun is moving behind the horizon. A clinician can help the patient with verbal instructions. Although skin temperature spectral characteristics have been shown to indicate stress-related changes of peripheral vasomotor activity in normal subjects (See: xe2x80x9cSpontaneous skin temperature oscillations in normal human subjectsxe2x80x9d, by: Shusternan et al., pp. 1173-1181), there has been no disclosure of the use of variations in skin-temperature response to assist in diagnosing ADHD. (See: Biofeedback and Self-Regulation, Vol. 20, No. 4, 1995).
PCT International Application WO 00/16687, published Mar. 30, 2000, discloses a method and device for determining depth of anesthesia. A pattern of very low frequency oscillations in measured skin temperature is defined and analyzed. The frequency band width of a frequency domain analysis of the oscillatory pattern, or the correlation between simultaneous oscillatory patterns measured at different physical locations, are used separately or fused to obtain an index of depth of anesthesia. There is no disclosure of the use of variations in skin temperature response to assist in diagnosing ADHD.
As discussed above, the primary method for diagnosing ADHD is the use of a bank of written and verbal assessment instruments designed to assess criteria established by American Medical Association (AMA) as described in the Diagnostic and Statistics manual -IV (DSM-IV) and administered by the school psychologist or other licensed practitioner. In some cases those individuals who meet DSM-IV criteria for ADHD diagnosis are prescribed a drug such as Ritalin. Behavioral observations of the patient while on Ritalin are conducted to assess the impact of prescribed medication.
U.S. patent application Ser. No. 09/597,610, describes an apparatus and method of determining whether an individual has Attention Deficit Hyperactivity Disorder by analyzing physiologic reactivity patterns (lower average Mrange) when the subject is asked to sit quietly in a low stimulus environment for a short period of time.
There are many factors, which can contribute to a change in skin temperature variability besides ADHD. The largest potential source of error is stress due to causes other than the sensory deprivation included in the test. Other extraneous causes of reduced peripheral temperature variability (TV) might include disease states, room temperature variation, etc.
The primary feature of U.S. patent application Ser. No. 09/597,610 is to diagnose subjects with ADHD. There is no attempt made to treat the condition once it has been diagnosed.
According to the present invention, there is provided a solution to the problems discussed above.
According to a feature of the present invention, there is provided a method of determining whether an individual has Attention Deficit Hyperactivity Disorder (ADHD) comprising: sampling the peripheral skin temperature of a human subject during a predetermined time interval when the subject is in an inactive state to provide a sampled peripheral skin temperature signal containing noise: modulating said sampled peripheral skin temperature signal containing noise with a known reference signal to produce a modulated signal; inputting said modulated signal and said known reference signal to a lock-in amplifier to produce a sampled peripheral skin temperature signal free of said noise; and analyzing the sampled peripheral skin temperature signal for a pre-selected parameter to determine whether said predetermined parameter has a value indicative of ADHD.
The invention has the following advantages.
1. A technique for diagnosing ADHD is provided which is simple, inexpensive, reliable and provides a level of accuracy improved over the prior art.
2. A technique for treating ADHD is provided.